Who will decide what health care you may receive? Will it be you, in conjunction with your doctor? Or will it be the government?

I’ll give you a hint. Under ObamaCare, the government will soon account for a whopping 66% of overall health spending. This means most health spending will consist of the government spending other people’s money on your behalf (and your money on others) — a sharp contrast to other necessities such as food and shelter, where people generally spend their own money on themselves.

Margaret Thatcher once noted that socialist systems fail because “they always run out of other people’s money.” But there are four additional dangers in a health system based on spending Other People’s Money:

1) Doctors will be increasingly expected to save money “for the system”

As Scott Gottlieb noted in the Wall Street Journal, physician pay will be increasingly linked to adherence to government “appropriate use criteria” for medical treatments that may not necessarily apply to you as an individual patient. Any outliers will be penalized. This will divide doctors’ loyalty between the government (who controls their salary) and you, the patient. How exactly that loyalty will be split will depend on the doctor.

Suppose you come to your doctor with a bad headache. He examines you and says, “Nope, you don’t need an expensive MRI. Just take two Tylenol and call me in the morning.” Can you trust that he is acting in your best medical interests rather than being improperly swayed by government incentives to control costs?

2) This will further fuel the nanny state

When everyone has to pay for everyone else’s health costs, how you live your life becomes everyone else’s business. Are you eating too much sugar? Do you smoke? Do you ride a motorcycle without a helmet? Individual freedoms will be increasingly restricted if deemed too costly to “society.”

As writer Steve Schweitzberger observed: “If Michael Moore has a toothache, it is not my responsibility to pay for his dentistry. If it were, then I would have the right to tell him not to eat sweets. I don’t want that kind of government-paid medical policy. Do you?”

3) Health benefits will become increasingly politicized

When the government pays for health care, it must also define what constitutes “essential health benefits” — which may or may not be “essential” to you as an individual. The result will be enormous special interest lobbying over which services should be covered by government-approved insurance plans.

According to the New York Times, special interest lobbyists succeeded in getting acupuncture considered “essential” in California, Maryland, New Mexico, and Washington. Also, “insurance plans will have to cover weight-loss surgery in New York and California, for example, but not in Minnesota or Connecticut. Infertility treatment will be a required benefit in Massachusetts, but not in Arizona.” Under such a system, the winners will be those with the most political “pull.”

4) Sooner or later, government spending Other People’s Money means the government taking your money

After her insurance rates skyrocketed, ObamaCare supporter Cindy Vinson told the San Jose Mercury News, “Of course, I want people to have health care… I just didn’t realize I would be the one who was going to pay for it personally.”

Similarly, Barbara Meinwald told the New York Times, “she was a lifelong Democrat who still supported better health care for all, but had she known what was in store for her, she would have voted for Mitt Romney.”

It’s no secret that many on the political Left desire a “single payer” system of government-run health care — the ultimate form of paying for health care with Other People’s Money.

Socialized systems which attempt to guarantee a supposed “right” to health care can only do so by violating the actual rights of those obliged to pay for it. As economist Walter Williams noted, “If one person has a right to something he did not earn, of necessity it requires that another person not have a right to something he did earn.”

Instead of entrenching a health system based on spending Other People’s Money, we should adopt free-market reforms that protect the individual’s right to spend his own money for his own medical benefit according to his best judgment. For many people, an excellent option would be a health savings account (HSA), where patients can deposit their own money tax-free to be spent later for medical needs. Most patients use HSAs for routine predictable expenses (e.g., flu shots, well-baby checks), coupled with high-deductible “catastrophic” insurance to cover unlikely-but-expensive serious accidents and illnesses. Patients with HSAs enjoy comparably good medical outcomes as patients with traditional insurance, while spending significantly less.

Over time, free-market reforms would also make health care far more affordable. No one argues about how to guarantee “universal” cellphone access. Instead, our relatively free market has made cellphones so inexpensive that even many of the poorest households can afford one. In the least regulated sectors of medicine such as cosmetic surgery and LASIK eye surgery, we see a similar pattern of falling prices and rising quality that we take for granted with cellphones and computers. This can and should be the norm in all of health care.

(There will always be a few unfortunate individuals who cannot afford basic health care through no fault of their own. In a free market they would likely be a very small minority. In my opinion, their needs should be handled by private charity. However, I recognize this would require a political consensus that does not yet exist. Until we reach that point, government-funded medical care for the poor should be clearly designated as such, rather than being hidden in various cross-subsidies of ObamaCare insurance. That way, taxpayers funding such programs can debate their desired size and scope in as fully informed a fashion as possible.)

ObamaCare entrenches a dangerous system based on spending Other People’s Money. The government will soon control a majority of U.S. health spending. Hence it will inevitably seek to control your health care. To regain control over your health care, you must regain as much control as possible over your health spending.

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